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2022-RA-948-ESGO Neoadjuvant Chemotherapy (NACT) and Interval Debulking Surgery (IDS) in a Group of Patients with Advanced Stage Epithelial Ovarian Cancer, Unsuitable for Upfront Surgery
  1. Ayesha Siddiqua1,
  2. Foujia Sharmin1,
  3. Silvia Hossain1,
  4. Kazi Mobina Akhter1,
  5. Anwar Hossain2 and
  6. Rehana Perveen1
  1. 1Gynaecological Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
  2. 2Medical Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh


Introduction/Background Neoadjuvant chemotherapy (NACT) has been advocated for patients with advanced stage epithelial ovarian carcinoma (EOC) with an aim to improve resectibility rate and survival. In this study we reported our experience in patients with advanced stage epithelial ovarian cancer.

Methodology This was a prospective observational study conducted at National Institute of Cancer Research & Hospital, Dhaka, Bangladesh from November,2018 to November,2019 for a period of 1 year. Advanced-stage EOC (FIGO stage-III and IV) patients with poor performance status (Eastern Co-operative Oncology Group scale 3 and 4), had received 3–6 cycles of 3weekly paclitaxel 175 mg/m2 and carboplatin AUC5 or AUC6. Response evaluation was done after 3rd and 6th cycle according to RECIST(Response evaluation criteria in solid tumor) criteria. Interval debulking surgery (IDS) was performed, unless there was evidence of disease progression. The primary end point was the proportion of patients made suitable for surgery. Statistical analysis was done by using SPSS version 23. Chi-square (χ2 ) test and Fisher’s Exact test were done, p-value less than 0.05 was taken as a level of significance.

Results Fifty patients were eligible for the study. They received the protocol treatment with NACT. Complete response was obtained in 46% cases and partial response 32%, stable disease 16%, progressive disease 6%. IDS was performed in 47 patients and 3 returned to chemotherapy with change schedule due to progressive disease. Complete resection (R0) rate was 53.2%, optimal resection (R1) 21.30% and suboptimal resection (R2) 19.10%. Complete (R0) resection was achieved in cases with complete response to NACT in 91.30% of patients, p < 0.000.

Conclusion Neoadjuvant chemotherapy for primary unresectable ovarian cancer leads to the selection of a subset of patients sensitive to chemotherapy in whom cytoreduction can be achieved in a high proportion of cases.

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